(REQ-5) Request a copy of employee records
Information on this form collected under the authority of section 26 (c) of the BC Freedom of Information and Protection of Privacy Act and is used for the
purpose of responding to your request. Questions can be directed to the designated FOI officer for the location of the records you are seeking.
Rev. 2018-05
REQUEST A COPY OF EMPLOYEE RECORDS
Please ensure all applicable fields are completed to avoid delays with your request
PLEASE USE FORM REQ-1 IF YOU ARE REQUESTING YOUR OWN HEALTH RECORDS
Part 1Requestor Information (Who is making the request for example, a law firm)
Last Name
First Name
Organization Name if applicable (e.g., Law firm)
Phone Number (during business hours)
City
Province
Postal Code
Part 2 - Employee Information (information about the employee whose records are being sought)
Last Name
First Name, Middle Name(s)
Employee ID
Phone Number (during business hours)
Date of Birth (yyyy-mmm-dd)
Date of Death, if applicable (yyyy-mmm-dd)
Part 3 - Records Requested
3.1 Standard Employee Records: Check all of the standard employee record types that you are requesting
Payroll Records
Job Description Records
HR Employment File & Benefits Records
Occupational Health & Safety Records
3.2 Non Standard Employee Records: Describe other types of records you are seeking. Please be specific and provide where Island Health
should search for the records you are seeking. Non Standard Employee Record Requests typically take longer to process than Standard
Employee Record Requests.
3.3 Date Range of Records Requested:
Date From (yyyy-mmm-dd)
Date To (yyyy-mmm-dd)
Part 4 Employee Consent
I consent to the release of my records identified in PART 3 (Records Requested) of this form to the individual/organization identified in
PART 1 (Requestor Information) of this form:
Note: if you are a law office or legal representative, an attached signed authorization or legal authorization is also acceptable
Employee Name (Print)
Employee Signature
Date Signed (yyyy-mmm-dd)
Requests for records are typically processed within 30 business days, which is about 43 calendar days. Some requests may take longer due
to volume of records, extent of search time, or if insufficient detail has been provided in your request. For example, requests such as ‘all
my other documents’ may not be possible to process without specific search criteria and details of the records being sought. Requests that
involve searching of corporate records (e.g., ‘all my work e-mails’) may attract fees as permitted by FIPPA.
When you have completed this form, please send it to:
E-mail to: FOI@viha.ca
Fax to: 250-519-1908
Mail to: Att. Information Stewardship, Access & Privacy; 1952 Bay Street; Victoria, BC, Canada, V8R 1J8
If you have questions, please call 250-370-8585
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